2025 Parent/Guardian Release for Young Adult and Youth Gathering

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Page 1

Program Participant

Participant's First Name

Participant's Last Name

Participant's Date of Birth

Which program is your child in?

High School Program (rising 10th grade and older)Junior Gathering (birth - rising 9th grade)

Is this the participant's first time in the HS program?

YesNo

High schoolers will be required to sign High School Program Guidelines and Expectations during check-in on the first day of the event. You may read the guidelines online here.

Participant's Sponsor

Will you as parent/guardian be attending the event with your child?

YesNo

Will the parent or sponsor be sleeping on campus or commuting?

CampusCommuting

Sponsor Name (if parent/guardian is not attending Gathering)

For commuting parents/sponsors

Name of overnight sponsor

If an overnight sponsor is not named above, I (or my child’s sponsor) will identify an overnight sponsor who is sleeping on campus no later than High School first-night orientation.

Yes

As a parent/guardian, I have asked this sponsor to act on my behalf at the FGC Gathering, which may include being alone with my child. Please initial below:

In the event of temporary absence from the FGC Gathering, the sponsor named above is authorized to designate a Temporary Sponsor. Please initial below:

Parent/Guardian Information for ALL Youth Participants

This section must be completed by parents/guardians for all participants. If parent/guardian is NOT attending the FGC Gathering, please also name sponsor in box above.

Parent/Guardian's First Name

Parent/Guardian's Last Name

Monthly/Yearly Meeting

Other Quaker affiliation (organization, school, camp etc.)

Parent/Guardian's Street Address

City

State/Province

Zip/Postal Code

Country

Daytime phone (include area code)

Evening phone (include area code)

Cell phone (include area code)

Parent/Guardian's email address

Alternate Emergency Contact

Name

Relationship to child